Comorbid NSTEMI and Cancer is Associated With Increased In-Hospital Mortality

Patients hospitalized with non-ST-segment elevation myocardial infarction (NSTEMI) and comorbid cancer have increased length of stay, inpatient mortality, and 30-day all-cause readmission rates compared with patients with NSTEMI without cancer. These findings were presented at the Transcatheter Cardiovascular Therapeutics (TCT) Scientific Symposium 2022 held from September 17th through 19th, in Boston, Massachusetts.

Investigators assessed the impact of cancer on inpatient NSTEMI strategies and outcomes with use of the Nationwide Readmission Database.

The participants were adults admitted for acute NSTEMI in 2017 and 2018. The researchers analyzed temporal trends in admissions, length of stay, mortality, procedural use, and 30-day readmission rates. The patients were stratified for cancer status, excluding metastatic cases.

A total of 754,557 patients (mean age, 68.1 years; 40.0% women) were admitted for acute NSTEMI. Of these patients, 3% had a comorbid cancer diagnosis. The patients with cancer were older, more likely to be women, and less likely to have a previous NSTEMI.

Length of stay, inpatient mortality, and 30-day all-cause readmissions were higher in patients who had cancer (P <.001 for all), according to multivariate regression analysis adjusted for demographics, chronic comorbidities, smoking, previous infarctions, and history of coronary angioplasty.

The participants with nonmetastatic cancer were approximately 27% less likely to have percutaneous coronary intervention (P <.001). Patients who had percutaneous coronary intervention with a diagnosis of concomitant cancer were less likely to receive drug-eluting stents (80.1% vs 90.1%; P <.001).

The patients with cancer were 61.7% more likely to die in the hospital (95% CI, 1.47-1.78; P <.001), after propensity score matching.

“Significant disparities were noted in temporal trend analysis between patients with and those without cancer presenting with NSTEMI,” the study authors noted. “Additional studies are needed to identify modifiable factors related to these differences.”